Provider Demographics
NPI:1962058479
Name:PA STATE HOME CARE LLC
Entity type:Organization
Organization Name:PA STATE HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:ALOIAN
Authorized Official - Suffix:
Authorized Official - Credentials:HOME CARE
Authorized Official - Phone:267-709-3553
Mailing Address - Street 1:3035 FRANKS RD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-4216
Mailing Address - Country:US
Mailing Address - Phone:267-709-3553
Mailing Address - Fax:215-397-3665
Practice Address - Street 1:3035 FRANKS RD
Practice Address - Street 2:
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-4216
Practice Address - Country:US
Practice Address - Phone:267-709-3553
Practice Address - Fax:215-397-3665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-12
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA44143601Other44143601